• Cătălina Simeanu "Sfântul Ioan" Clinical Emergency Hospital Bucharest, Romania
  • Răzvan Iosifescu ”Sfântul Ioan" Clinical Emergency Hospital Bucharest, Romania & "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
  • Marius Zamfir "Prof. dr. Alexandru Trestioreanu" Institute of Oncology Bucharest, Romania & "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
  • Camelia Călin "Sfântul Ioan" Clinical Emergency Hospital Bucharest, Romania
  • Mara Mardare "Prof. dr. Alexandru Trestioreanu" Institute of Oncology Bucharest, Romania & "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
  • Andrei Văcărașu "Prof. dr. Alexandru Trestioreanu" Institute of Oncology Bucharest, Romania
  • Irina Bondoc "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology Bucharest, Romania
  • Niculae Iordache "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology Bucharest, Romania & "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
  • Dan Nicolae Păduraru General Surgery Department, University Emergency Hospital, Bucharest, Romania & “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • Octav Ginghină "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology Bucharest, Romania & "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
Keywords: mucocele, appendicular neoplasm, appendicitis, appendectomy


Malignant tumors of the appendix can be classified into mucinous epithelial neoplasms, neuroendocrine tumors (typical carcinoids), goblet cells or composite carcinoids, lymphomas, adenocarcinomas and lymphoid or mesenchymal sarcomas. Histologically, more than half of appendicular tumors are of neuroendocrine origin, while the rest are adenocarcinomas (mucinous, signet ring or non-mucin-secreting). These tumors are rarely suspected before surgery, the final diagnosis being intraoperative and established by histopathological examination. Appendiceal mucinous neoplasms represent an extremely small percentage of all appendectomy specimens. We present the case of a 44-year-old patient who presented to the Emergency Unit of "Saint John" Clinical Emergency Hospital Bucharest with an altered general condition, severe pain in the right iliac fossa associated with episodes of nausea, vomiting and fever. On admission, the clinical examination of the patient revealed a spontaneously painful abdomen, exacerbated on palpation in the right iliac fossa that associated signs of peritoneal irritation with accelerated intestinal transit. Biological constants indicated a microcytic hypochromic anemia. The result of the contrast computed tomography of the abdomen and pelvis identified acute appendicitis with right parietocolic appendicular plastron. Emergency surgery was decided and under general anesthesia, laparoscopic appendectomy with drainage of the peritoneal cavity was performed. The postoperative evolution was favorable and the patient was discharged on the 7th postoperative day.

The histopathological examination of the appendectomy specimen established the diagnosis of infiltrative mucinous adenocarcinoma at the level of the adventitia. After multidisciplinary team meeting, given the histopathological findings, right ileohemicolectomy with ileo-transverse anastomosis was decided and performed. The patient is under oncological surveillance with periodic assessment, being currently disease free. Appendicular mucinous neoplasms are a rare disease for which diagnostic and therapeutic management is a challenge. Appendiceal mucocele remains a rare cause of acute surgical abdomen.


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